Pain Medicine Curriculum

1. Painful Disease States

a. Pathophysiology

1) Acute Pain PMBoxedPMBoxed

2) Cancer-Related Pain PMBoxedPMBoxed

3) Chronic Pain States

a) Acute and Chronic Neck and Low Back Pain PMBoxedPMBoxedPMBoxedPMBoxed

b) Neuropathic Pain States PMBoxedPMBoxedPMBoxedPMBoxed

(1) Complex Regional Pain Syndrome, Types I and II PMBoxedPMBoxedPMBoxedPMBoxed

(2) Postherpetic Neuralgia PMBoxedPMBoxed

(3) Phantom Limb, Post-Stroke PMBoxedPMBoxedPMBoxedPMBoxedPMBoxedPMBoxedPMBoxedPMBoxed

(4) Peripheral Neuropathies (e.g., Diabetic Neuropathy) PMBoxedPMBoxedPMBoxed

c) Somatic Pain Conditions: Myofascial Pain, Facet Arthropathy, etc. PMBoxedPMBoxedPMBoxedPMBoxed

b. Treatment

1) Acute Postoperative and Posttraumatic Pain PMBoxed

a) Postoperative Epidural Analgesia PMBoxedPMBoxedPMBoxed

b) Neuraxial Opioids PMBoxedPMBoxedPMBoxed

c) Peripheral Nerve Blockade and Catheters PMBoxedPMBoxedPMBoxedPMBoxedPMBoxedPMBoxed

d) Patient-Controlled Analgesia PMBoxedPMBoxed

e) Other Modalities, Multimodal Analgesia (Nonsteroidal Analgesics, Electrical Stimulation, Acupuncture, Ketamine, etc.) PMBoxedPMBoxedPMBoxed

2) Cancer-Related Pain PMBoxedPMBoxedPMBoxed

a) Systemic Medications, Tolerance and Addiction PMBoxedPMBoxedPMBoxedPMBoxedPMBoxedPMBoxedPMBoxed

b) Continuous Spinal and Epidural Analgesia PMBoxedPMBoxedPMBoxedPMBoxed

c) Neurolytic and Non-Neurolytic Blocks PMBoxedPMBoxedPMBoxed

d) World Health Organization Analgesic Ladder PMBoxedPMBoxed

3) Chronic Pain (Non-Cancer-Related)

a) Systemic Medications: Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), Opioid Analgesics, Anticonvulsants, Antidepressants


b) Spinal and Epidural Analgesia PMBoxedPMBoxedPMBoxedPMBoxedPMBoxed

c) Peripheral Nerve Blocks PMBoxedPMBoxedPMBoxed

d) Sympathetic Nerve Blocks PMBoxed

 e) Other Techniques: TENS, Spinal Cord Stimulation, Neuroablation (Surgical and Chemical Neurolysis PMBoxedPMBoxedPMBoxedPMBoxedPMBoxed

2. Central and Peripheral Nervous Systems

a. Physiology

1) Pain Mechanisms and Pathways

a) Nociceptors and Nociceptive Afferent Neurons, Wind-Up Phenomenon PMBoxedPMBoxedPMBoxed

b) Dorsal Horn Transmission and Modulation PMBoxedPMBoxedPMBoxed

c) Spinal and Supraspinal Neurotransmission and Modulation; Opioid Receptors PMBoxedPMBoxedPMBoxedPMBoxedPMBoxed

d) Autonomic Contributions to Pain; Visceral Pain Perception and Transmission PMBoxedPMBoxed

e) Social, Vocational and Psychological Influences on Pain Perception PMBoxedPMBoxedPMBoxedPMBoxed

3. Postoperative Period

a. Pain Relief

1) Pharmacologic

a) Drugs: Opioids, Agonist-Antagonists, Local Anesthetics, Alpha-2 Agonists, Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), N-Methyl-D-Aspartate (NMDA) Receptor Blockers, tricyclic antidepressants (TCA), selective serotonin reuptake inhibitor (SSRI)

b) Routes: Oral, Subcutaneous (SC), Transcutaneous, Transmucosal, Intramuscular (IM), Intravenous (IV), Including Patient-Controlled Analgesia (PCA), Epidural, Spinal, Interpleural, Other Regional Techniques PMBoxedPMBoxedPMBoxedPMBoxedPMBoxedPMBoxedPMBoxedPMBoxedPMBoxedPMBoxedPMBoxed

2) Other Techniques; Transcutaneous Electrical Nerve Stimulation (TENS); Cryotherapy; Acupuncture, Hypnosis PMBoxedPMBoxedPMBoxedPMBoxedPMBoxedPMBoxed